Prevention and treatment of osteoporosis aims to stop bone loss and rebuild bone to prevent fractures. Along with making life-style changes, there are several medication choices. Some will slow your rate of bone loss, and others can help rebuild bone. Talk with your doctor to see if one of these is good for you:
- Alendronate and risedronate.
These 1medicines are bisphosphonates, drugs that slow the breakdown of bone and increase bone density. They can lessen your chance of breaks in the spine, hip, and other bones. Side effects may include nausea, heartburn, and stomach pain. A few people have muscle, bone, or joint pain while using these medicines. These drugs must be taken in a certain way — when you first get up, before you have eaten, and with a full glass of water. You should not lie down or eat for at least one-half hour after taking the drug. They can cause serious digestive problems. These are available in both once-daily and once-a-week versions. - Calcitonin
This is a naturally occurring hormone that increases bone mass in the spine and may lessen the pain of fractures already there. It comes in two forms — injection or nasal spray. The injection may cause an allergic reaction and has some unpleasant side effects. The only side effect of the nasal spray is a runny nose in some people. Although it is not prescribed often, calcitonin is most useful for women who are 5 years past menopause. - Raloxifene
This drug is approved to prevent osteoporosis. It is a SERM (selective estrogen recep-tor modulator). It prevents bone loss and spine fractures, but may cause hot flashes or increase the risk of blood clots in some women. - Estrogen
Doctors sometimes prescribe estrogen at the time of menopause to slow the rate of bone loss and to increase bone mass in the spine and hip. Estrogen alone, called estrogen replacement therapy (ERT), is used in postmenopausal women who have had the uterus removed (hysterectomy). Postmenopausal women who still have a uterus and choose to take estrogen also receive a progestin to protect the lining of the uterus. This is called hormone replacement therapy (HRT). There are risks with long-term use of these hormones. HRT increases the risk of breast cancer, heart disease, stroke, and blood clots, but lowers the risk of hip and other fractures and colorectal cancer. Estrogen increases the risk of uterine cancer in a woman with a uterus who does not take a progestin and also the risk of blood clots. Each woman thinking about ERT or HRT should discuss benefits, risks, side effects, and other possible treatments with her doctor. - In the future
Other SERMs and bisphosphonates are being studied as improved prevention or treatments for osteoporosis. Also promising as a possible therapy is parathyroid hormone (PTH).
